US 8196374 B2
A lancet integrated test element tape includes a plurality of lancet integrated test elements. The lancet integrated test elements each include a lancet configured to form an incision in tissue and a test element configured to analyze body fluid from the incision in the tissue. A cartridge includes a supply compartment configured to store an unused section of the tape. The tape is folded within the supply compartment to limit damage to the lancet integrated test elements. The cartridge can further include a waste compartment in which a used section of the tape is stored. An indexing mechanism moves the tape between the supply and waste compartments.
1. A method, comprising: assembling on a sterility sheet a plurality of test elements configured to analyze body fluid; enclosing in the sterility sheet a plurality of piercing members configured to pierce tissue, wherein each piercing member is associated with one of the test elements to create a tape of integrated sampling elements; sterilizing the piercing members; and said assembling on the sterility sheet the plurality of test elements comprising assembling one or more components of the test elements that are unaffected by said sterilization on the sterility sheet prior to said sterilization, and assembling one or more components of the test elements that are affected by said sterilization on the sterility sheet after said sterilization; folding the tape after said enclosing to create a folded tape section; and packing the folded tape section into a supply compartment of a cartridge; and forming on the sterility sheet a plurality of guide members configured to guide the tape in the cartridge.
2. The method of
the test elements comprise electrochemical sensors.
3. The method of
folding the sterility sheet around the piercing members; and
sealing the sterility sheet around the piercing members.
4. The method of
5. The method of
6. The method of
7. The method of
forming tractor holes in the sterility sheet.
8. A method, comprising:
joining a tape of lancets and a tape of test elements at least at alternating fold lines; and
folding the tape of the lancets and the tape of the test elements in an accordion manner in which the lancets and the test elements are folded away from one another.
9. The method of
packing the tape of the lancets and the tape of the test elements in a cartridge in a stacked manner.
10. The method of
folding a sterility sheet around the lancets; and
sealing the sterility sheet around the lancets.
11. The method of
sterilizing the tape of the lancets separately from the tape of the test elements.
12. The method of
manufacturing the tape of the test elements to be wider than the tape of the lancets.
13. The method of
positioning the lancets on the tape to have blank sections in between folds; and
positioning the test elements on the tape to have blank sections in between folds.
This application is a divisional of U.S. application Ser. No. 12/359,368, filed Jan. 26, 2009 now U.S. Pat. No. 8,083,992, which is a divisional of U.S. application Ser. No. 11/326,422, filed Jan. 5, 2006, now U.S. Pat. No. 7,481,777, which are hereby incorporated by reference.
The present invention generally relates to bodily fluid sampling devices and more specifically, but not exclusively, concerns a dispenser for lancet integrated test element units that is configured to minimize the risk of damage of the units prior to use.
The acquisition and testing of bodily fluids is useful for many purposes and continues to grow in importance for use in medical diagnosis and treatment, such as for diabetes, and in other diverse applications. In the medical field, it is desirable for lay operators to perform tests routinely, quickly, and reproducibly outside of a laboratory setting, with rapid results and a readout of the resulting test information. Testing can be performed on various bodily fluids, and for certain applications, is particularly related to the testing of blood and/or interstitial fluid. Performing home-based testing can be difficult for many patients, especially for patients with limited hand dexterity, such as the elderly or diabetics. For example, diabetics can sometimes experience numbness or tingling in their extremities, such as their hands, which can make self-testing difficult because they are unable to accurately position a test strip to collect the blood sample. In addition, wounds for diabetics tend to heal more slowly, and as a result, there is a desire to make incisions less invasive.
Recently, lancet integrated test strips or elements have been developed in which a test strip is integrated with a lancet or other piercing means so as to form a single disposable unit. While these integrated units have somewhat simplified the collection and testing of fluid samples, there are still a number of issues that need to be resolved before a commercial unit can be implemented. One issue concerns maintaining the sterility of the lancet prior to use so as to minimize the risk of infection. Another issue concerns the disposal of used units after use. Once used, the integrated units become a biohazard that need to be disposed of in a safe manner. A number of different types of systems have been proposed for dispensing test strips, lancets, or some combination thereof, but most of these systems have significant drawbacks, especially when used in conjunction with integrated units.
In one typical design, individual test strips are stacked within a cartridge. The test strips are usually dispensed on an individual basis either manually or via a sliding mechanism. Since test strips are dispensed individually, automatic handling of the test strips is rather complicated. The sliding mechanism can jam during dispensing, which can damage the test strips. Usually, after use, the test strips have to be disposed of manually via a separate waste container.
Individual test strips or elements have been formed and/or connected together to form tapes of test strips. In one design, the tape is folded within a case, and individual test elements are manually dispensed by pulling on the tape. However, in the age of smaller fluid sample sizes in which the size of test strips becomes smaller, manual feeding and handling of the tape is not practical due to the size of the test strips involved. Such manual feed designs also fail to provide for automatic feeding of the tape and automatic disposal of used sections of the tape, which are typically needed for modern systems. To address these concerns, automatic feed systems like reel-to-reel cassettes have been developed.
Reel-to-reel type cassettes of test strips, which are similar in construction to normal audio cassettes, address a number of test strip handling and storage issues found with previous test strip cartridge designs. However, it has been recognized that there are still a number of significant drawbacks to reel-to-reel type cassettes, especially for electrochemical test strips, lancet integrated test strips, and other disposables that contain components susceptible to damage. For example, if electrochemical test strips are tightly wound around a reel in the cassette, the electrodes within the test strip can be bent or damaged in such a way to create a short, an open condition, or otherwise damage the electrodes, thereby making the test strip unusable. Similarly, if tightly wound around a reel, lancets within integrated units can be bent or otherwise damaged, which in turn can cause injury to the user or otherwise prevent successful lancing of the skin. To combat this problem, tapes of test strips or integrated units are loosely wound around the reels. However, the loosely wound tape makes the cassettes larger than desired and/or reduces the number of tests available before requiring reloading a new cassette. Even when the tape is initially wrapped in a loose manner, the tape can become tightly wrapped as the tape is indexed, thereby damaging the tape. In addition, reel-to-reel type cassette designs are prone to operating in reverse, which can cause the reintroduction of used test strips into the sterilized supply compartments.
Thus, needs remain for further contributions in this area of technology.
One aspect concerns a lancet integrated test tape that includes a plurality of lancet integrated test units. The lancet integrated test units each include a lancet configured to form an incision in tissue and a test element configured to analyze body fluid from the incision in the tissue. A cartridge includes a supply compartment configured to store an unused section of the tape. The tape is folded within the supply compartment to limit damage to the lancet integrated test units.
Another aspect concerns a tape that includes a plurality of test elements configured to analyze body fluid. A cartridge includes a supply compartment configured to store an unused section of the tape. The unused section of the tape is folded within the supply compartment. The cartridge further includes a waste compartment configured to store a used section of the tape. An indexing mechanism is configured to index the tape between the supply compartment and the waste compartment.
A further aspect concerns a tape that includes a plurality of test elements configured to analyze body fluid. A cartridge includes a supply compartment configured to store an unused section of the tape. The unused section of the tape is folded within the supply compartment. The cartridge further includes a waste compartment configured to store a used section of the tape. The used section of the tape is folded within the waste compartment.
Still yet another aspect concerns a technique in which a plurality of test elements are configured to analyze body fluid are assembled on a sterility sheet. A plurality of piercing members configured to pierce tissue are enclosed in the sterility sheet. Each piercing member is associated with one of the test elements to create a tape of integrated sampling elements.
Further forms, objects, features, aspects, benefits, advantages, and embodiments of the present invention will become apparent from a detailed description and drawings provided herewith.
For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated device, and such further applications of the principles of the invention as illustrated therein being contemplated as would normally occur to one skilled in the art to which the invention relates. A number of embodiments of the invention are shown in detail; although it will be apparent to those skilled in the relevant art that some features that are not relevant to the present invention may not be shown for the sake of clarity. It should be noted that directional terms, such as “up”, “down”, “top” and “bottom”, are used herein solely for the convenience of the reader in order to aid in the reader's understanding of the illustrated embodiments, and it is not the intent that the use of these directional terms in any manner limit the described, illustrated, and/or claimed features to a specific direction or orientation.
As mentioned previously, there have been a number of drawbacks prior cartridge or cassette designs. For example, tapes of lancets, test strip and/or lancet integrated test element (LIT) units can be damaged if tightly wound around a supply reel of a reel-to-reel cassette or other cassette types. To address these issues as well as other concerns, a LIT tape according to one embodiment is stored in a folded manner within a supply compartment. By being stored in a folded manner, the tension applied to the tape during indexing is typically applied to only a few of the LIT units, which in turn reduces the chance of the LIT units being damaged. To further reduce the chance of damaging the LIT units, a feed mechanism can be used to automatically feed the tape between the supply and waste compartments of the cartridge. The feed mechanism allows the LIT units to be positioned properly for lancing and sample collection without the need for any user manipulation.
A LIT tape 19 according to one embodiment, among many, will be described initially with reference to
As can be seen in
As shown, end stops 32 of the retainer 28 extend inwardly at a slot opening 34 of the guide slot 31 so as to limit the movement of the lancet 30, thereby retaining the lancet 30 in the guide slot 31. The lancet 30 has a body portion 35 with one or more stop edges 36, which are wider than the slot opening 34. When the lancet 30 is fully extended, the stop edges 36 of the lancet 30 can contact the end stops 32, and thus, limit the travel of the lancet 30. However, in other embodiments, the firing mechanism, which is used to fire the lancet 30, limits the travel of the lancet 30. A neck portion 37 of the lancet 30, which is slightly smaller that the size of the slot opening 34, extends from the body portion 35 of the lancet 30. During extension of the lancet 30, the neck 37 is received between the end stops 32 such that the end stops 32 can limit undesirable rotation of the lancet 30 as the tissue is punctured. Extending from the neck 37, the lancet 30 has a blade portion or tip 38 that is configured to cut tissue. In the illustrated embodiment, the lancet defines an engagement notch 39 for coupling the lancet 30 to a firing mechanism. In one form, the lancet assembly 22 is made at least in part of medical grade stainless steel, but it should be recognized that the lancet assembly 22 can be made of other materials, such as ceramics and/or plastics. Furthermore, it is contemplated that the guide member 28 and the lancet 30 can be made of different materials and/or manufactured separately. In one embodiment, the guide member 28 and lancet 30 are formed by a photo-etching technique in which a sheet of metal is photo-etched to form both the guide member 28 and the lancet 30, and in another embodiment, the lancet assembly 22 is manufactured via stamping. The lancet assembly 22 in still other embodiments can be manufactured through other techniques as would occur to those skilled in the art.
With reference to
As depicted, the integrated lancing test strips 20 in one embodiment are formed in a continuous process. In the continuous process, the sterility sheet 24 is a continuous band that is rolled off a reel and folded around a continuous band or belt of lancet assemblies 22 that are likewise rolled from a reel. The lancet assemblies 22 are sealed between the flaps 40 of the sterility sheet 24 and the test elements 26 are attached to the sheet 24 in the manner as described above. The sterility sheet 24 joins adjacent LIT units 20 together to form the continuous LIT tape 19. Between the individual units 20, the sterility sheet 24 has folds or weakened lines 43 that allow the tape 19 to be folded in a fan-fold fashion for storage. The fold lines 43 can also be configured to allow individual units 20 to be detached from one another. The sterility sheet 24 can be weakened at the fold lines 43 in any number of manners as would occur to those skilled in the art. For example, the sheet 24 can be scored or thinned at the fold line 43, and it is contemplated that the fold line 43 can be continuous or discontinuous. The fold lines 43 can be formed before the lancet assembly 22 is covered by the sterility sheet 24 or afterwards. It is envisioned that the fold line 43 in other embodiments can be optional such that the tape 19 naturally folds in a fan-fold or other fashion.
Once joined together, the lancet assembly 22 and the sterility sheet 24 form a lancet package or packet 44. As mentioned before, the lancet assembly 22 can be sterilized before being enclosed in the sterility sheet 24 or afterwards. The lancet assembly 22 can be sterilized through any number of sterilization techniques as would occur to those skilled in the art, such as through chemical, heat, and/or radiation sterilization techniques, to name a few. It should be understood that all or part of the lancet assembly 22 can be sterilized. For instance, only the lancet 30 and guide slot 31 can be sterilized, if so desired. In another embodiment, the lancet assembly 22 is sterilized after the lancet assembly 22 is packaged inside the lancet package 44. In one form, a radiation sterilization technique is used once the lancet 30 is enclosed by the sterility sheet 24. With the lancet package 44, sterilization of the lancet assembly 22 can occur without exposing the test strip 26 to the undesirable affects of lancet sterilization. Consequently, the lot specific calibration data can be generated before the lancet package 44 is attached to the test strip.
In the illustrated embodiment, the test strip 26 is an electro-chemical type test strip. In one particular form, the test strip 26 includes a modified version of any of the ACCU-CHEK® brand test strips (Roche Diagnostics GmbH), but it is envisioned that other types of test elements can be used. For example, the test strip 26 in other embodiments can include an optical type test strip or can analyze fluid samples in other manners. At one end, the test strip 26 in the illustrated embodiment includes a connection portion 46 with electrical contacts 47 that transmit sample readings to a meter. Opposite the connection portion 46, the test strip 26 has a capillary channel 48 with a capillary opening 49 that is configured to draw a body fluid sample from an incision formed by the lancet 30 via capillary action. As should be appreciated, the test strip 26 inside the capillary channel 48 includes an analysis region that includes electrodes, such as working, counter and reference electrodes, and reagents for analyzing the fluid sample. In one form, the connection portion 46 is connected to a meter, and the sample readings from the electrodes in the analysis region are transmitted to the meter via the electrical contacts.
As briefly noted before, the sterilized lancet package 44 is attached to the test strip 26 to form the integrated lancing test strip unit 20. As depicted, the lancet package 44 is attached at the end of the test strip 26 proximal to the capillary opening 49 of the capillary channel 48. In particular, the guide slot opening 34 of the lancet assembly 22 and the capillary opening 49 of the test strip 26 are positioned near one another in a side-by-side relationship so that when the lancet 30 forms the incision, the capillary channel opening 49 is positioned in close proximity to collect the body fluid. The test strip 26 is attached to the exterior of the sterility sheet 24 enclosing the lancing member 22 to complete the integrated test strip 20. The test strip 26 in one form is attached to the lancet package 44 through an adhesive, but it should be recognized that the test strip 26 and lancet package 44 can be attached in other manners. In one form, the lancet package 44 is attached to the test strip 26 such that the end edges of both are aligned with another. However, in other embodiments the edges of the lancet package 44 and the test strip 26 can be offset from one another. For example, the edge of the lancet package 44 in the illustrated embodiment, as is demarked by crease 42, is recessed slightly from the edge of the test strip 26 at the capillary opening 49. By having the lancet package 44 recessed, fluid flow to the capillary channel opening 49 is promoted. In another example, the sterility sheet 24 is positioned such that the crease 42 extends past the edge of the test strip 26. With this example, all or part of the sterility sheet 24 can be hydrophobic and/or hydrophilic so as to direct fluid flow towards the capillary channel 48. In one particular form, the sterility sheet 24 extends from the test strip 26 such that the sterility sheet 24 acts like a flexible wicking flag that draws fluid into the capillary channel 48.
To draw the body fluid towards the capillary channel opening 49 and away from the lancet 30, the test strip 26 in the illustrated embodiment has a fluid direction notch facing the lancet package 44. In order to enhance fluid flow towards the capillary channel opening 49, the sterility sheet 24 can be treated and/or made to be hydrophobic. With the sterility sheet 24 being hydrophobic, the sterility sheet can squeegee or wipe body fluid from the lancet 30 as the lancet 30 retracts back inside the guide slot 31. It is thought that the wiping action of the sterility sheet 24 increases the amount of body fluid available for sampling as well as makes the lancet 30 cleaner for disposal purposes. As noted before, with the lancet 30 sealed in the lancet package 44, the risk of cross-contamination between the lancet 30 and the test strip 26 is reduced.
A cartridge or cassette 60 in which the test element tape 19 is housed in illustrated in
In contrast, the tape 19 in
Between the supply compartment 62 and the waste compartment 64, the cartridge 60 has a sampling portion 66 where the LIT units 20 sample body fluid and a stabilizer arm 68 that stabilizes the connection between the compartments 62, 64. The sampling portion 66 and/or stabilizer arm 68 can be optional or eliminated in other embodiments. As depicted, the sampling portion 66 and the stabilizer arm 68 define a meter cavity 70 in which at least a portion of the meter is received. In one embodiment, the firing cam arm of the meter, which is configured to engage the engagement notch 39 in the lancet 30 during lancing, extends within the meter cavity. In the embodiment depicted, the sampling portion 66 is generally enclosed to assist in maintaining the sterility of the cartridge 60, but the sampling portion 66 still incorporates a number openings that are used to engage the LIT unit 20 during sampling. Referring to
With reference to
To index the tape in the cartridge 60, the meter includes an indexing mechanism 100 that engages the socket 80 in the reel 78 of the cartridge 60. In the illustrated embodiment, the indexing mechanism 100 includes a rotatable knob 102 that rotates a drive shaft 104, which in turn engages the socket 80 in the reel 78. The user indexes the tape 19 in the cartridge 60 by manually rotating the knob 102, but in other embodiments, a motor can be used to automatically index the tape 19. The indexing mechanism 100 can further incorporate a ratchet type mechanism to prevent the indexing mechanism 100 from operating backwards, thereby reducing the chance of reintroducing a contaminated section of the tape 19 back into the supply compartment 62 of the cartridge 60. In another embodiment, the indexing mechanism 100 operates in a fashion similar to a camera in which the firing button can only be actuated when the LIT unit 20 is properly positioned over the sample opening 74 in the cartridge 60. After the lancet 30 is fired, the indexing mechanism 100 is used to move the now used LIT unit 20 into the waste compartment 64.
To use the meter 92, the user rotates the indexing knob 102 such that the tape 19 in the cartridge 60 moves an unused LIT unit 20 into position over sample opening 74 in the cartridge 60, and once moved into position, the contacts 108 of the meter 92 engage the contacts 47 of the unused LIT unit 20. The tape 19 can be indexed before or after the user places the meter system 90 against the skin or other tissue to be lanced. To minimize the risk of contamination or infection, the user typically indexes the tape 19 after the test has been performed so that the used/contaminated LIT unit 20 is stored in the waste compartment 64. Once the system 90 is placed against the incision site (or in close proximity to the site), the user presses the firing button 98, which causes the lancet 30 (
An integrated test element tape 110 according to another embodiment will now be described with references to
The tape 110 can by manufactured and sterilized via a number of techniques. As should be recognized, the lancet 22 can be sterilized utilizing any number of sterilization techniques. Moreover, the lancet 22 can be sterilized before being enclosed in the sterility sheet 24, or afterwards, such as through radiation sterilization. Some sterilization techniques are detrimental to the chemistry of reagents. A number of manufacturing techniques can be used to address this issue. In one embodiment, the lancet 22 is sterilized and enclosed within the sterility sheet 24 before the electrodes 112, the reagent 114, and other components of the LIT units 116 are applied to the sterility sheet 24. This technique reduces the chance of the chemistry in the reagent 114 being affected by the sterilization of the lancet 22. In another embodiment, some or all of components for the LIT units 116, which are not affected by the sterilization of the lancet 22, are attached prior to sterilization of the lancet 22. For instance, in one technique, the electrodes 112 are formed on the sterility sheet 24 before the lancet 22 is sterilized and enclosed in the sterility sheet 24. With another technique, the electrodes 112, spacer 118, and vent member 120 are attached to the sterility sheet 24 prior to the sterilization and enclosure of the lancet 22. After sterilization, the reagent 114 is deposited into the capillary channel 48 on or near the electrodes 112, and the cover sheet 124 is then applied over the capillary channel 48. In still yet another embodiment, all of the components of the test element, including the reagent 114, are assembled on the sterility sheet 24. Afterwards, the lancets 22 are sterilized and packaged in the sterility sheet 24 (or vice versa). In order to compensate for the affects of sterilization, the lot calibration readings, which are used to calibrate a meter prior to testing, are taken after the assembled units 116 have been sterilized.
A test element tape 126 with individual LIT units 128 according to another embodiment will be described with reference to
A cartridge 144 in which the test element tape 126 is housed illustrated in
A variation of the
A sampling portion 170 extends between the supply 166 and waste 168 compartments. In one form, the sampling portion 170 is integrated into the cartridge 164, and in other forms, the sampling portion 170 is separate from the cartridge 164 (e.g., incorporated into the meter and/or elsewhere). In the depicted embodiment, the sampling portion 170 includes guides 154 for guiding the tape 160, the feed mechanism 156, and the sample opening 74 where the fluid sample is collected. The sampling portion 170 can be open to the outside environment, partially open, or fully closed to the outside environment. The tractor feed mechanism 156 indexes the tape 160 by engaging the tractor holes 138 in the manner as previously described. It should be recognized that the tape can be indexed in other manners, and the feed mechanism 156 can be located elsewhere, such as in one of the compartments 166, 168 or on the meter, to name just a few examples. To guide the tape 160 as the tape 160 unfolds and folds, the compartments 166, 168 in the illustrated embodiment include one or more guide surfaces 172 that are configured to guide the alignment members 142 on the tape 160. As should be appreciated, the tape 160 can be unguided or guided in other manners as the tape 160 folds and unfolds.
A tape system according to yet another embodiment will be initially described with reference to
With reference to
For storage purposes, the tapes 174, 176 can be folded in a wide variety of fashions.
In the supply compartment 190, the test elements 178 and the lancet elements 182 are packed in a stacked configuration. In other words, the test elements 178 in the test element tape 174 are folded upon one another, and the lancet elements 182 in the lancet tape 176 are folded upon one another. This results in the folded sections of the test element 174 and the lancet 176 tapes being positioned in a side-by-side fashion. As the feed mechanism 156 indexes the LIT tape 186, the LIT tape 186 unfolds in an accordion fashion. Once the LIT tape reaches the sampling portion 194, opposing guides 154 straighten the LIT tape 186 such that test element 174 and lancet 176 tapes are sandwiched together. Consequently, the test 178 and lancet 182 elements are brought together to create a LIT unit 196, at least on temporary basis. In the illustrated embodiment, opposing guides 154 squeeze the tapes 174, 176 together, but in other embodiments, other mechanisms can be used to press the tapes 174, 176 together. Once indexed over the sample opening 74, the lancet unit 182 of the LIT unit 196 can be used to form an incision from which a fluid sample is drawn and analyzed via the test element 178 of the LIT unit 196.
Afterwards, the now used LIT unit 196 is indexed into the waste compartment 192. In the waste compartment 192, the test element 174 and lancet element 176 tapes spread apart in an accordion fashion until the LIT tape 186 is folded in a stacked fashion like in the supply compartment 190. With such a construction, the packing density of the LIT tape 186 is enhanced such that the length of the supply 190 and waste 192 compartments can be shortened. Moreover, the risk of cross contamination between the test elements 178 and the lancet elements 182 before use is reduced because the test elements 178 and lancet elements 182 remain generally apart prior to use and only come into full contact just before use.
A variation of a test element tape 198 and lancet tape 200 that can be used in the cartridge 188 of
From the previous discussion, it should be appreciated that the LIT units as well as the meters can be used to sample and analyze body fluid from various body parts like fingers and alternate sites, such as the forearm, for example. Moreover, the LIT units can be used to analyze numerous types of body fluids, such as interstitial fluid and blood, to name a few examples. The body fluid samples can be collected from body fluid bled onto the surface of the tissue or can be directly drawn from below the surface of the tissue. It also should be recognized that the features of the cartridges can be modified for use in other types of meters besides the one illustrated in the drawings. Conversely, the above-described meters can be used in conjunction with other types of cartridges. The cartridges and/or tapes can include machine readable coding that can provide a wide variety of information, such as lot coding and calibration information. For instance, the cartridges can include machine readable coding like barcodes, radio frequency identification (RFID) tags, magnetic encoding, electronic memory chips, and/or identification resistors, to name a few examples.
It is envisioned that that compartments in the cartridges can be integrated together to form a single unit or can be separate. Further, the waste and supply compartments in other embodiments can incorporate springs or other biasing members to bias the tapes. Moreover, the supply compartments can include desiccants for stabilizing the humidity of the supply compartments.
Regarding the tapes for the above-discussed embodiments, it is contemplated that a leader section can be incorporated into the tapes. It also should be appreciated that the tapes can be folded and/or oriented in other manners, besides in the manners as illustrated in the drawings. Furthermore, the LIT units in further embodiments can be configured in manners different from those shown in the drawings. For example, the lancet can be immovable or fixed relative to the test element. In another example, the lancet retracts via a rotational movement instead of linearly and/or the lancet extends at an angle relative to the opening of the capillary channel. It is contemplated that selected features from the various embodiments can be combined together in any number of other combinations. For instance, the waste compartment reel shown in
While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected. All publications, patents and patent applications cited in this specification are herein incorporated by reference as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated by reference as set forth in its entirety herein.